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Today’s question was answered by the Morselicious Alex Caspero, Registered Dietitian and owner of Delicious Knowledge.
Q. I have been troubled most of my life with what is probably IBS- bloating/excessive pungent wind/constipation etc etc. All advice for this seems to be to increase fibre/vegetables/fruit etc- which I did but my stomach never felt any better until someone suggested that I may have fructose malapsorbtion- I cut out most vegetables/fruit- stuck to starchy white producta and I couldn’t believe it- almost instant results- my digestion is 90% improved- also skin is better etc. I do eat bananas, spinach and tomatoes and lots of oily fish and take supplements- but a massive reduction in fibre has helped me so much. The rainbow diet that you suggest would play havos with my stomach!
A. If you are interested in bettering your health through nutrition, you’ve likely become an expert in which foods are considered to be healthy: “vegetables, fruits, whole grains, low-fat proteins, healthy fats, nuts, beans.” That’s a pretty comprehensive list that covers most of the basics, whether you follow a vegan, vegetarian, flexitarian, or omnivore diet.
But sometimes this kind of plan DOESN’T work. For those suffering with food sensitivities, allergies, IBS, mal-absorption issues, and others- the advice to eat more fruits, vegetables, whole grains can actually backfire.
As a LEAP therapist, I work with finding out what types of foods are healing and which ones promote inflammation. Even healthy sounding foods, like broccoli, salmon, kale, and apples can cause symptoms of IBS, fibromyalgia, migraines, UC, GERD, and others in individuals who are sensitive to these types of foods. It’s all about knowing your body and what works for you.
To deal with these problems, it is necessary to know which foodstuffs are causative. The most accurate test is for the affected person to be a “detective” and to recognize that ingesting a particular foodstuff predictably causes certain symptoms. One of these test, the Mediator Release Test, identifies 150 different foods and chemicals that might make you sick. A LEAP therapist will then help you with your diet based on the results.
Sometimes, the problem relies in food families that are easier to identify and thus avoid: celiac, gluten intolerance, fructose malabpsorption, heart burn. If you suspect that a food is making you sick, even if it’s considered to be ‘healthy’, my first suggestion is to avoid it! However, it doesn’t mean that you are stuck to an intake of energy-dense, nutrient-deprived food.
Let’s take the example of fructose malabsorption. the diet used to treat is called FODMAPS, which stands for Fermentable Oligo-,Di-and Monosaccharides and Polyols Diet. I know, try saying that 5 times fast!
The basic premise is that some people have trouble digesting FODMAPS, especially those with IBS or other bowel disorders. FODMAPS are not easily absorbed by the bowel and may include symptoms such as abdominal discomfort, bloating, fullness, nausea, pain after eating foods that contain them.
Fructans and Galactins
- Fructose
- Lactose
- Fructooligosaccharides
- Galactooligosaccharides
Polyols
- Sorbitol
- Mannitol
- Xylitol
- Maltitol
General guidelines are to remove intake of HFCS, sugar alcohols, limit products that contain fructose, honey, on the label. Tolerance is also depended on the amount you ingest. It doesn’t mean that you have to forgo fruits all together. Blackberries, blueberries, grapefruit, honeydew, melons, oranges, pineapples, raspberries, strawberries, are all considered to be FODMAP friendly, especially at low servings.
While most vegetables are also limited, those that typically cause the least amount of discomfort include bok choy, carrots, celery, leafy greens, potatoes, and root vegetables.
If you do need a FODMAP diet, I recommend not filling up on foods that contain very little nutrients. Instead, find foods that are GI friendly but also provide beneficial nutrients: friendly fruits and vegetables, low-fat meats, nuts, healthy fats, plain yogurt, & eggs.
The bottom-line: While a plant-based diet is usually seen as the best approach to a diet to prevent chronic disease & maintain a healthy weight- it’s not a one-size fits all approach. Listen to your body and your individual needs. If you need to avoid or add in other foods to make it right for your needs, you have the permission to do so.
Alexandra Caspero, MA, RD, is owner of Delicious Knowledge in Sacramento, Calif. She specializes in plant-based diets, sports nutrition, food intolerance and weight management. Read her blog at Delicious-Knowledge.com and follow her on Twitter @DelishKnowledge.